Provider Demographics
NPI:1437220555
Name:LOVETT FOURNIER, ERICA D (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:D
Last Name:LOVETT FOURNIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:D
Other - Last Name:LOVETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:510 29 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5383
Mailing Address - Country:US
Mailing Address - Phone:970-298-1782
Mailing Address - Fax:970-298-1726
Practice Address - Street 1:510 29 1/2 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5383
Practice Address - Country:US
Practice Address - Phone:970-298-1782
Practice Address - Fax:970-298-1726
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016802207Q00000X
CO0054686207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME143722055Medicaid
CO96422777Medicaid
MENE143101Medicare PIN
ME143722055Medicaid
CO400766ZLHGMedicare PIN